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The Core- Beyond The Spine

The Core consists of structures that make up Lumbo-Pelvic-Hip Complex (LPHC). It includes the lumbar spine, pelvic girdle, abdomen, diaphragm and hips. It is where body’s center of gravity is located and where all movement originates.

A strong and efficient core is necessary for maintaining proper muscle balance throughout the entire Human Movement System (Kinetic Chain).

Optimal length-tension relationships in muscles, joint kinematics and recruitment patterns of the core muscles, enable the Kinetic Chain to function with optimal neuromuscular efficiency. This is a prerequisite for efficient movement acceleration, deceleration, and stabilization in all planes of motion and is essential for prevention of injuries.

The core can be subdivided into three distinct but interrelated systems:

Local

Global

Movement

Local Stabilization System

Local stabilizers are muscles that attach directly to vertebrae. They consist primarily of slow twitch type I fibers and function to limit excessive compressive, shear, and rotational forces between spinal segments.

The primary muscles that make up local stabilization system include transverse abdominis, internal obliques, multifidus, pelvic floor musculature, and diaphragm.

Global Stabilization System

Muscles of global stabilization system attach from pelvis to the spine. These muscles transfer loads between upper extremity and lower extremity, provide stability between pelvis and spine, and provide stabilization and eccentric control of the core during functional movements. The primary muscles that make up global stabilization system include quadratus lumborum, psoas major, external obliques, portions of the internal oblique, rectus abdominis, gluteus medius, and adductor complex.

Movement System

The movement system includes muscles that attach the spine and/or pelvis to the extremities. These muscles are primarily responsible for concentric force production and eccentric deceleration during dynamic activities. Muscles that make up movement system include latissimus dorsi, hip flexors, hamstring complex, and quadriceps.

Collectively all muscles within each system provide dynamic stabilization and neuromuscular control of entire core. They produce force concentrically, reduce force eccentricity, and provide dynamic stabilization isometrically in all planes of movement during functional activities.

Core Integration

In isolation, the core muscles do not effectively achieve stabilization; rather stability is achieved through their synergistic interdependent functioning that enhances segmental and global neuromuscular control.

This concept is essential when designing a core strengthening program, which should combine flexibility, Intramuscular Activation and multi-planar, compound functional movements.

Chronic ankle sprains have been associated with weaker hip abduction strength and less plantar-flexion range of motion on the involved sides. Therapists should consider exercises to increase hip abduction strength when developing rehabilitation programs for patients with ankle sprains.